Safeguarding services for GPs in Camden Deborah Hodes Designated Doctor for Safeguarding Camden

Safeguarding services for GPs Service/organisation Service provision

How common are these conditions? In numbers per 1000 Child protection plan5 Looked after children 5 Child in need 51 Cerebral palsy 1 Fetal alcohol syndrome 2 Severe learning disability 3.7 Sensorineural hearing loss 1-2 Down syndrome 0.5

WHO

Camden CCG Safeguarding Team 5 Executive Lead for Safeguarding Children Designated Doctor Safeguarding Director of Quality& Clinical Effectiveness Designated Nurse LAC Designated Nurse Safeguarding GP Lead for Safeguarding Designated Doctor CDOP CCC Board Designated Doctor LAC

Camden Safeguarding Children Board 6 CSCB Quality Assurance Sub -group Camden Safeguarding Children Board CSCB NHS Safeguarding Committee CSCB Learning & Development Sub -group CSCB CP Support & Challenge Panel CSCB Serious Case Review Panel CSCB Child Death Overview Panel CSCB E- Safety Group CSCB CP Complaints Panel CSCB Community Engagement Group CSCB Safer Recruitment Group

Trust safeguarding teams Named paediatricians Named nurses Named midwife Named GP Named mental health – children & adult

Safeguarding concerns/suspicion or allegation of maltreatment

Is the child acutely sick, in pain, bleeding or has “medical” problems? YesNo Will the child be at immediate risk of abuse when he/she leaves the surgery? No Mon- Fri 9-5 Discuss with Child Protection Team Hotline Tel Refer for assessment to the Safeguarding Children Clinic Child Protection Team, Crowndale H.C 59 Crowndale Road, London NW1 1TU Fax Not Sure Mon-Fri 9-5 Discuss with On –call community team Child Protection Team Hotline Named doctor Tel GP Lead Claire Taylor Designated Nurse Jackie Dyer Designated Doctor Deborah Hodes Out of Hours Duty Social Worker Team On call Paediatric Registrar at acute trust Yes Mon - Fri 9 -5 Refer to MASH Tel Tel Out of hours Or dial 999 in emergency NB. All referrals to be followed in writing within 48hrs Contact the on-call Paediatric Registrar University College Hospital Tel Whittington Hospital Tel Royal Free Hospital Tel You see a child and suspect abuse or neglect Child Protection Guidelines for General Practitioners in Camden

Is the child acutely sick, in pain, bleeding or has “medical” problems? YesNo Will the child be at immediate risk of abuse when he/she leaves the surgery? No Mon- Fri 9-5 Discuss with Child Protection Team Hotline Tel Refer for assessment to the Safeguarding Children Clinic Child Protection Team, Crowndale H.C 59 Crowndale Road, London NW1 1TU Fax Not Sure Mon-Fri 9-5 Discuss with On –call community team Child Protection Team Hotline Named doctor Tel GP Lead Claire Taylor Designated Nurse Jackie Dyer Designated Doctor Deborah Hodes Out of Hours Duty Social Worker Team On call Paediatric Registrar at acute trust Yes Mon - Fri 9 -5 Refer to MASH Tel Tel Out of hours Or dial 999 in emergency NB. All referrals to be followed in writing within 48hrs Contact the on-call Paediatric Registrar University College Hospital Tel Whittington Hospital Tel Royal Free Hospital Tel You see a child and suspect abuse or neglect Child Protection Guidelines for General Practitioners in Camden

Is the child acutely sick, in pain, bleeding or has “medical” problems? Phone and refer to paediatrician nearest hospital MASH Police

Is the child acutely sick, in pain, bleeding or has “medical” problems? YesNo Will the child be at immediate risk of abuse when he/she leaves the surgery? No Mon- Fri 9-5 Discuss with Child Protection Team Hotline Tel Refer for assessment to the Safeguarding Children Clinic Child Protection Team, Crowndale H.C 59 Crowndale Road, London NW1 1TU Fax Not Sure Mon-Fri 9-5 Discuss with On –call community team Child Protection Team Hotline Named doctor Tel GP Lead Claire Taylor Designated Nurse Jackie Dyer Designated Doctor Deborah Hodes Out of Hours Duty Social Worker Team On call Paediatric Registrar at acute trust Yes Mon - Fri 9 -5 Refer to MASH Tel Tel Out of hours Or dial 999 in emergency NB. All referrals to be followed in writing within 48hrs Contact the on-call Paediatric Registrar University College Hospital Tel Whittington Hospital Tel Royal Free Hospital Tel You see a child and suspect abuse or neglect Child Protection Guidelines for General Practitioners in Camden

Will the child be at immediate risk of abuse when he/she leaves the surgery? YES Ring MASH – duty social worker

Is the child acutely sick, in pain, bleeding or has “medical” problems? YesNo Will the child be at immediate risk of abuse when he/she leaves the surgery? No Mon- Fri 9-5 Discuss with Child Protection Team Hotline Tel Refer for assessment to the Safeguarding Children Clinic Child Protection Team, Crowndale H.C 59 Crowndale Road, London NW1 1TU Fax Not Sure Mon-Fri 9-5 Discuss with On –call community team Child Protection Team Hotline Named doctor Tel GP Lead Claire Taylor Designated Nurse Jackie Dyer Designated Doctor Deborah Hodes Out of Hours Duty Social Worker Team On call Paediatric Registrar at acute trust Yes Mon - Fri 9 -5 Refer to Duty Social Worker Team Contact either Tel (North Team) Tel (South Team) Out of hours Or dial 999 in emergency NB. All referrals to be followed in writing within 48hrs Contact the on-call Paediatric Registrar University College Hospital Tel Whittington Hospital Tel Royal Free Hospital Tel You see a child and suspect abuse or neglect Child Protection Guidelines for General Practitioners in Camden

Will the child be at immediate risk of abuse when he/she leaves the surgery? NOT SURE D/W - Named doctor/nurse for SG - Hotline D/W duty social worker Consider referral to OPD – community or UCLH tertiary SG or FGM clinic for paediatric OPD Refer to MASH for social work

Is the child acutely sick, in pain, bleeding or has “medical” problems? YesNo Will the child be at immediate risk of abuse when he/she leaves the surgery? No Mon- Fri 9-5 Discuss with Child Protection Team Hotline Tel Refer for assessment to the Safeguarding Children Clinic Child Protection Team, Crowndale H.C 59 Crowndale Road, London NW1 1TU Fax Not Sure Mon-Fri 9-5 Discuss with On –call community team Child Protection Team Hotline Named doctor Tel GP Lead Claire Taylor Designated Nurse Jackie Dyer Designated Doctor Deborah Hodes Out of Hours Duty Social Worker Team On call Paediatric Registrar at acute trust Yes Mon - Fri 9 -5 Refer to MASH Tel Tel Out of hours Or dial 999 in emergency NB. All referrals to be followed in writing within 48hrs Contact the on-call Paediatric Registrar University College Hospital Tel Whittington Hospital Tel Royal Free Hospital Tel You see a child and suspect abuse or neglect Child Protection Guidelines for General Practitioners in Camden

Will the child be at immediate risk of abuse when he/she leaves the surgery? NO D/W colleagues in surgery/social worker/named doctor/nurse Refer for paediatric assessment at Crowndale health – consultant led for concerns re non urgent child abuse and neglect

Safeguarding services for GPs Other organisations you link in with and how is information shared?

Camden’s Multi-Agency Safeguarding Hub MASH December 2012 MASH is a multi-agency process which facilitates sharing information in order to safeguard children. Safe quick multi-agency information shared safely and quickly to safeguard children. Information shared, informs decisions, ensure safeguarding activity & intervention are timely, proportionate & necessary.

Agencies: Camden MASH Some collocated SWs Police Officers MASH Liaison Health Visitor Housing Probation Camden Safety Net Youth Offending Service UCLH Royal Free 24 GP Practices CRI Substance Misuse Services Children’s Society Missing Children Interviews All agencies above have signed the MASH Information Sharing Agreement.

Camden MASH activity MASH manager reviews: Police Merlin’s (these referrals made by the police of children under age of 18 where there are concerns about their safety and welfare) e-CAF Referrals (electronic Common Assessment Framework Tool Form) Emergency Duty Team Reports All telephone calls re concerns about a child/family

Camden MASH activity Does the case meets the MASH criteria using a Rag Rating System? If yes: Before the MASH Team review each case the Social Care Team contact the parents to obtain consent. Red and Amber

Camden’s MASH Red – High Risk (To be dealt with within 4 hours) Immediate and serious safeguarding concerns requiring action Information package completed within four hours Police and children social care teams to be told immediately with research to follow. Amber - Medium risk (To be dealt with within 24 hours) Significant concerns however no immediate action required However a S.47 enquiry is likely Information package completed within 24 hours Awaiting and or outstanding checks to be made clear on the child’s case file (in case notes section)

Camden MASH activity Does the case meets the MASH criteria using a Rag Rating System? If lower level of need: i.e. case does not reach the threshold for safeguarding, but an identified need, so reeferral to the Early Help Team, who identify the appropriate service for support. Green and Blue

Camden’s MASH Green – Low Risk (To be dealt with within 3 days) Concerns about a child's wellbeing however it is felt that this could be managed under S.17 Children Act MASH product to be completed within three working days. Blue – Signpost onto Early Help as there is no identified need for FSSW

Camden’s MASH MASH Update Reports September 2013 demonstrated in December 2012 – August referrals to Social Care 502 (29.5%) of these were reviewed by the MASH Team 10% drop in repeat referrals to social care

Questions